Medical marijuana allowed in Connecticut, dispensaries months away

By Mark Zaretsky, Register Staff

Saturday, October 6, 2012

Connecticut took the controversial, historic step as of Oct. 1 to become the 17th state to legalize marijuana for medicinal use.

Now what?

In what some in the government and the medical community described as a compassionate effort to make the drug available to cancer patients and others who may benefit from its effects, the state quickly put in place a mechanism for doctors to certify eligible patients and for patients to receive temporary medicinal marijuana ID cards.

But detailed regulations governing how patients will receive the drug and who will grow and dispense it still are months away.

For now, doctors can prescribe the medication and patients with valid ID cards are allowed to have it, but they are on their own as far as how and where they obtain it, officials said.

Patients suffering from one of the illnesses covered by Connecticut's law, said to be the most restrictive among the 17 state laws so far in place, need written authorization from their doctor, said Michael Lawlor, undersecretary for criminal justice policy and planning in the state Office of Policy and Management.

Connecticut's law allows properly registered patients "to lawfully possess up to one month's supply of marijuana," Lawlor said. "For the time being, one month's supply is 2.5 ounces."

"Regardless of how someone came into possession" of the marijuana "or if they are growing their own, if they are properly registered, et cetera, they cannot be arrested," Lawlor said.

Once regulations are in place, "the state will license growers" and, ultimately, "you will obtain it via licensed pharmacists who will be specially authorized to sell it," Lawlor said.

Marijuana won't be available at the local Walgreens or CVS, however, and "whether insurance covers it is up to the insurer," he said.

"It all starts with the doctor, so that if the doctor certifies it ... the patient can then register as a qualified patient and they will receive from us a card which identifies them as a qualified patient," said state Consumer Protection Commissioner Bill Rubenstein.

"We're not advising people how to get marijuana, but it was the compassionate judgment of the General Assembly ... that people who" suffer from debilitating illnesses that can be made less painful through the use of marijuana should be able to get it sooner rather than later, Rubenstein said.

THREE-STEP APPLICATION

Under Connecticut's law, an application for a temporary registration certificate will be available online and registration will involve a three-step process. Doctors initiate the process by certifying patients, who then can go online to complete the patient portion of the application. If the physician certifies the need for a primary caregiver, the caregiver also can log in after the patient and complete the application.

One prominent advocate of medicinal marijuana, Dr. Andrew L. Salner, chief of the Department of Radiation Oncology and director of the The Helen & Harry Gray Cancer Center at Hartford Hospital, said that while he hasn't yet certified any patients to receive medical marijuana, he wouldn't hesitate to.

"On the one hand, I think that we really need to wait for the Deptartment of Consumer Protection to put in place the regs ... and hopefully in a matter of months, that will be ready to go," Salner said. "But on the other hand, there are people who can benefit from it."

And while "it's a relatively small percentage of my patients who can benefit from it," he said, estimating that it's probably less than 5 percent, there are some patients for whom "that's going to help" lessen their pain, reduce nausea or stimulate their appetites.

Salner worries that certifying patients now, before a legally authorized distribution system is in place, can put those patients or their families "potentially in harm's way," but "at least it may help them from the danger of prosecution," he said.

"I think there right now is a bit of hesitancy from some doctors to write the certification ... because they are pushing patients onto the black market," said Erik Williams, executive director of the Connecticut chapter of NORML, the National Organization for the Reform of Marijuana Laws.

But even with only part of Connecticut's medicinal marijuana program in place, for would-be recipients, "as of Monday, when marijuana became legal for people who are certified ... that changed the legal framework for them -- dramatically.

"Yes, we certainly would want to see a means for production and distribution to be in place," Williams said. But "I'd say it's far and away the most well-crafted, regulated system out there" thus far.

The state is required to have the regulations in place by July 1, and "once accepted by the General Assembly, we can begin accepting applications" from would-be growers, said Rubenstein.

The law requires the state to have no fewer than three and no more than 10 certified growers authorized to participate in the program.

DIAGNOSIS NEEDED

To qualify for medicinal marijuana, a patient needs to be diagnosed by a Connecticut-licensed physician as having one of the following debilitating medical conditions: cancer, glaucoma, HIV, AIDS, Parkinson's disease, multiple sclerosis, damage to the nervous tissue of the spinal cord with "intractable spasticity," epilepsy, cachexia, wasting syndrome, Crohn's disease or post-traumatic stress disorder.

That list may be expanded at a later date. A Board of Physicians has been created to make such decisions.

Still not entirely worked out is how the price of medical marijuana will be set, Rubenstein said.

"I think the statute provides us a great regulatory latitude" and price "is something that we could consider in creating the regulations," he said, although "my preference would be to let the market set the price."

While he believes in the market, "our hope is that medical marijuana would be priced to cost," Rubenstein said, adding that "black market prices are generally higher than competitive prices."

While Connecticut's medicinal marijuana law has been described as the most restrictive yet passed -- an important detail when looking at recent federal intervention in California, where some believe medicinal marijuana has become too easy to obtain, "we've tried to take the best pieces of each" in crafting it, Rubenstein said.

"Looking at other states, we learned from good example and we learned from bad example," Rubenstein said. "We're treating this distribution system the way we would treat any controlled substance pharmaceutical manufacturing operation."

"Our task (in Connecticut) is really different than other states," he said. "Colorado licenses about 300 producers. Connecticut will license no more than 10."

One thing Connecticut doesn't allow authorized recipients to do -- as have some other states, such as Maine -- is grow their own, he said.

Patients also have to be a Connecticut resident at least 18 years old to obtain the drug, according to information on the website of the state Department of Consumer Protection, which regulates the drug's use. A prison inmate cannot qualify, regardless of medical condition.

The new law prohibits use of marijuana on any bus, school bus or any moving vehicle; in the workplace; and on the grounds of any school. It also prohibits use of marijuana in any public place or in the presence of anyone under age 18.

The law also prohibits any use of palliative marijuana that endangers the health or well-being of another person, other than the patient or primary caregiver.